Public entities discuss ambulance burden

By ANDY HALLMAN | Apr 26, 2013

Fairfield City Administrator Kevin Flanagan, left, and Jefferson County Supervisor Becky Schmitz discuss the future of the ambulance service during a meeting April 11 which included representatives from the Fairfield City Council, the Jefferson County Board of Supervisors and the Jefferson County Health Center Board of Trustees.

The question of who should provide and who should pay for an ambulance service in Jefferson County has come up at recent public meetings.

The Fairfield City Council discussed the ambulance service at its meeting Monday. The city does not contribute to the ambulance service, but it is a member of the ambulance board because of an intergovernmental agreement it signed with the Jefferson County Board of Supervisors and the Jefferson County Health Center Board of Trustees.

Councilor Michael Halley asked what the benefit is to the city of remaining a part of the intergovernmental agreement if the city does not contribute.

Fairfield City Attorney John Morrissey said even without the city’s contributions, Fairfield residents still pay two-thirds of the ambulance’s budget through other taxes.

Three local public bodies convened April 11 to talk about the future of the ambulance service.

Representatives from the Fairfield City Council, Jefferson County Board of Supervisors and Jefferson County Health Center Board of Trustees met at the hospital. Fairfield City Administrator Kevin Flanagan organized the meeting because he wanted to suggest to the other public boards that the hospital assume the responsibilities of the ambulance service.

Health administrator and CEO Deb Cardin said the hospital is six months into a five-year contract with its ambulance provider. She said the quality of the service is good.

Cardin said the hospital is not interested in assuming the responsibilities of providing an ambulance service to the county. She said it would only be a loss for the hospital, which would jeopardize the provision of other services.

Flanagan was not convinced it would jeopardize other services. He said he could not see how a $35,000 loss could hurt the hospital so much when it reported $2 million in profit last year.

Supervisor Lee Dimmit said he usually prefers services to be done by private enterprises instead of by the government, but he said the ambulance service is hardly a private enterprise.

“For all intents and purposes, it’s a public entity,” he said. “It’s private in name only because it’s being subsidized by taxpayers on multiple fronts.”

Gene Irwin, health center chief financial officer, said it would cost the hospital more to provide the ambulance service than a private firm since the hospital is required to pay benefits and IPERS.

Cardin said if the hospital assumed responsibility for the ambulance, it would still contract the work to a private entity so no money would be saved.

Flanagan wondered aloud how health center in towns Fairfield’s size are able to run an ambulance.

Renee Rebling, chairwoman of the hospital board, said the hospital is still waiting to feel the effects of the Affordable Care Act passed in 2010, so it is disinclined to take on another service and another expense.

Rebling also was curious why the city stopped contributing to the ambulance service a few years ago.

“Why did the city pull out a couple years ago and not support this service?” Rebling asked. “That just blows me away.”

Flanagan said city residents do pay for the ambulance service when they pay county and hospital taxes.

Flanagan added the city carries the weight on the provision of many services that benefit the whole county but are paid mostly or entirely by city residents. He mentioned the parks, fire department and library as services fitting that description. He suggested that might have been the reason the city stopped contributing to the ambulance service.

Bob Keller, health center board member, wondered why the April 11 meeting was called in the first place. He said the hospital is six months into a five-year contract with an ambulance provider. He said the real issue the governing bodies should be addressing is not finding a new provider but putting away money to purchase a new ambulance.

Flanagan said local governments also need to think about the long-term health of the ambulance. Cardin asked him what long-term plans he had in mind.

Flanagan said he would like the hospital to start building an ambulance barn in three years so it is ready to assume the service once the contract expires.

Another problem Flanagan wanted to resolve was what he called the lack of parity on the ambulance board. The board consists of one Fairfield city councilor, one Jefferson County supervisor and two representatives of the hospital board. He said it was not fair the hospital gets two representatives.